Corrected arm muscle area (CAMA), triceps skin-fold thickness (TSF) and body mass index (BMI) were measured in a community sample of 758 people who were then followed for 40-46 months. Percentile values were calculated for each sex in 5-year age groups. The relative risk of death of those in the upper and lower percentiles was compared with those between the 10th and 90th percentiles, controlling for age and sex. Subjects below the 5th percentile for CAMA, TSF and BMI and between the 5th and 10th percentile for CAMA had a significantly increased risk of death. There was no increased risk of death in those subjects above the 90th percentile in any measurement. In the logistic regression model, both low CAMA and low TSF were associated with a significantly increased risk of subsequent mortality. Poor nutritional state shown by low muscle bulk and fat stores was an important predictor of mortality, but obesity had no adverse effect on survival.

Study objective-The aim was to determine the prevalence and factors associated with constipation in elderly people.Design-The study was a survey involving administration of a structured questionnaire, an interview, and a dietary assessment.Setting-The survey was community based and the population studied was drawn from the practice records of all five general practitioners serving a rural township of 13 500 people.Participants Mosgiel is served by five family practitioners based at the Mosgiel health centre. Comparison with the electoral roll showed that 94% of the people living in the area were registered with the centre. Names, ages, and addresses of those 70 years and over on 1 August 1988 were obtained from the health centre records. The sample frame included those in the community and those in residential homes but did not include any person in continuing hospital care. The proportion of people living in residential homes was similar to that in the country as a whole.All subjects were seen in their homes by the research nurse who administered the initial questionnaire. This included questions on bowel habit, investigating frequency of bowel motions, straining, laxative use, food modification, and feelings of constipation. The subjects were left with a food frequency questionnaire to complete. This questionnaire was designed specifically for use with elderly people. It included a list of some 120 food and drink items and has been shown by comparison with five 2 d diet records to be a valid

Objective: To examine prospective changes in food habits and nutrient intakes in a representative New Zealand sample of community dwelling adults aged 70 y and over. Design: Longitudinal study with food intake data collected in 1988a89 and again in 1995a96. In an attempt to distinguish age, time and cohort effects, data were analysed longitudinally, cross-sectionally and timesequentially. Subjects: The sample for study consisted of all non-institutionalised people aged 70 years and over registered with the Mosgiel Health Centre in 1988. In 1988a89, 678 adults completed a dietary survey (85% of those eligible) and 248 adults participated again in 1995a96 (66% of those eligible). Results: Energy intakes declined longitudinally in men only; however, this decline appeared not to be an aging effect as energy intake was not found to decrease with age cross-sectionally. Percentage of energy from protein increased by 0.7% in women (95% con®dence interval 0.2 ± 1.2) in both the longitudinal and time-sequential analysis, suggesting a time effect. The percentage of energy from saturated fat decreased 0.7% (95% con®dence interval 7 1.4 to 7 0.1) and percentage of energy from polyunsaturated fat increased 0.4% (95% con®dence interval 0.0 ± 0.7) in women, and appears to be a time effect. However, the increase in saturated fat and decrease in polyunsaturated fat with advancing age seen cross-sectionally suggests a cohort effect also occurring. In 1995a96, more people were using margarine as a spread and vegetable oils to cook meat. Milk and milk product consumption increased (not signi®cantly), and meat intake decreased signi®cantly by 5 and 4 servings per month in men and women, respectively. There was an increase in the proportion of people who ate breakfast cereal at least once a week, and more women ate brown or wholemeal bread in 1995a96. Conclusion: Over the 6 y follow-up period studied, there was no indication of an age effect on nutrient intakes in adults aged 70 y and older; however, the changes occurring over time demonstrate that older adults, particularly women, are making changes towards healthier food choices. Sponsorship: Health Research Council of New Zealand and the University of Otago Medical School.

The usual alcohol intake in a community-based sample of subjects aged 70 years and over was investigated. A sample of 825 subjects was drawn from the records of five general practices in a rural township and 774 subjects (93.8%) agreed to participate. A stratified sub-sample of subjects from the abstainers, infrequent, weekly, and daily drinkers was subsequently investigated in more detail. Men took alcohol more frequently than women and in greater quantities although frequency and amount decreased with age. The usual place for drinking was the home. The highest use of psychotropic drugs occurred in the abstainers, but this was significant for men only. When compared with drinking patterns in middle age, 60.1% of men and 30.3% of women said that they took less alcohol, while 7.4% of men and 11.1% of women said that they took more. The main reasons for decrease in alcohol intake were change in health and fewer social opportunities. The main reasons for increase in alcohol intake were more money and more time. Drinking was most commonly associated with social activities and few took alcohol to help cope with personal situations.

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